| NPI | 1659712602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KS 04-46917) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: SC 81983) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SC MD81983) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0068243) | |
| Enumeration Date | 2013-07-07 |
| Last Update Date | 2022-11-04 |